Tension On Rise Over Mystery Disease

Officials Struggle To Understand Sars

Fear of a mysterious respiratory disease kept an American Airlines plane from Tokyo stuck for hours on the tarmac in San Jose, Calif., Tuesday, and prompted Greenwich Country Day School to tell more than 40 students and staff members who recently visited China to stay home.

Such scenes have become increasingly common around the world as health officials try to understand, track and contain potentially deadly SARS, or severe acute respiratory syndrome, a new contagious disease for which no diagnostic test exists.

Infectious disease experts remain uncertain about the true threat of SARS, but they now believe it may be caused by a mutated common cold virus that originated in China. SARS cases have been reported in 16 countries, with 1,804 cases, including 62 deaths, tallied by the World Health Organization. Hot spots include Hong Kong, Guangdong province in southern China, Singapore, and Hanoi, Vietnam.

In the United States, there have been no fatalities among 69 suspected cases reported by the Centers for Disease Control and Prevention. Three suspected cases have been identified in Connecticut, but none of the individuals has been seriously ill.

Most people known to have contracted the disease either have traveled to parts of Asia or come into close contact with someone who has the disease.

While there have been few secondary infections in the United States, health officials are concerned about the potential impact of ``super infectors'' or ``hyper-disseminators'' -- a handful of SARS patients who seem to be able to transmit the disease to large numbers of people.

Dr. Julie Gerberding, director of the CDC, said such SARS patients may hinder efforts to stop the spread of the disease.

``For example, in Hanoi ... there was one patient who was a source for health care worker transmission, and approximately 56 percent of the health care workers who had direct contact with the patient appeared to have acquired SARS,'' Gerberding said.

Without diagnostic tests to positively identify SARS, it is impossible to gauge just how contagious and dangerous the disease really is, said Dr. John Shanley, director of infectious diseases at the University of Connecticut Health Center.

``This is going to be a nightmare to deal with,'' Shanley said.

The global death rate of 1 percent to 3 percent reported for SARS seems frighteningly high, Shanley said, but it could be that tens of thousands more have been infected without exhibiting symptoms. If so, the SARS outbreak might seem less scary, but controlling its spread also would be much more difficult, if not impossible.

For now, health officials define a case as suspected SARS if the individual has a fever of at least 100.4 degrees, a dry cough and shortness of breath, and has traveled to Asia or been in direct contact with a SARS patient.

In other developments this week:

A 1-year-old girl adopted in China was identified as the third Massachusetts resident who may have contracted SARS. She was admitted to Baystate Medical Center in Springfield on March 21 and released four days later. The girl's aunt, a 40-year-old Springfield woman, traveled with her sister to Hong Kong and China in March. She was treated for SARS in Connecticut last week. The 1-year-old's mother did not become ill.

On the flight from Tokyo, two passengers and two crew members, plus a fifth unidentified person, complained of symptoms similar to those found in SARS. It was not immediately clear when the people became ill, but they reported to the crew during the flight that they thought they might have SARS.

Health officials believed four of the five may have transferred from Hong Kong to Tokyo. They now suspect that none of the five has SARS.

The United Nations health agency today advised travelers to avoid going to Hong Kong and Guangdong because of the SARS outbreak.